MEDICAL EYE EXAMS

MEDICAL EYE EXAMS

Comprehensive Medical Eye Exams include a detailed examination of the eye health as well as diagnosis and treatment plan for eye related medical conditions

Total Vision Care (TVC) is in network with most major medical insurances (see list of insurances accepted). Fees vary depending on the complexity of the exam. Self pay patients can call for an estimate of fees based on the service needed.

PURPOSE OF A MEDICAL EYE EXAM: Vision is not just a function of focusing and prescription for glasses. Vision requires a healthy eye so that all aspects of the visual pathway are functioning properly. If any part of the visual pathway is disturbed, poor vision may result.

WHO NEEDS A MEDICAL EYE EXAM?

All patients over age 60 are advised to receive annual medical exams due to the risk of medical problems including cataracts, glaucoma, dry eyes, and age-related macular degeneration.

Patients at any age who have been diagnosed with a medical problem are advised to keep regular follow up visits to monitor the condition being treated.

HOW IS A MEDICAL EXAM DIFFERENT THAN A ROUTINE VISION EXAM?

A medical exam includes all the aspects of a vision exam EXCEPT a refraction (a “refraction” is when you look through the phoroptor and are asked “which is better number one or number two?” and the result is given in the form of a glasses prescription).

Medical insurance does not allow a refraction to be bundled in with a medical eye exam. However, at TVC we only charge $35 for a refraction which can be done during your medical exam or during a separate visit as long as you are current on your eye exams.

A medical exam is a more thorough evaluation of the health of the eyes including:

Dry eye evaluation- several methods can be used to evaluate the tear function and its effect on vision and ocular health.

Cataracts- evaluation of cataracts includes grading the severity of the clouding of the lens and the effect on vision, night vision, and glare.

Intra-ocular pressure (IOP) measurement is important to monitor for signs of glaucoma.

Cornea- evaluation for any corneal dystrophies, injuries, scars, or keratitis (inflammation of the cornea).

Conjunctiva- evaluation of the conjunctiva for signs of infection, injury, cancer, scar tissue, or allergic conjunctivitis.

Eyelids- evaluation for signs of skin cancers, loss of eyelashes, inflammation of the meibomian glands in the lids (blepharitis), ectropion or entropion (lids turning out or in), ptosis (drooping of the eyelids).

Angle evaluation- the “angle” in the eye is the part responsible for draining fluid out of the eye. If the angle narrows or closes, the IOP can be elevated and cause headaches, pain, and loss of vision.

A dilated medical exam allows for a more detailed view of the back of the eye including:

Macula evaluation- the macula is the part of the retina responsible for central, detailed vision. Damage to the macula can occur from age-related macular degeneration, hereditary macular dystrophies, macular edema (swelling) from diabetes or other causes, holes and scars from trauma.

Retina- the entire retina is viewed during a dilated exam to rule out any damage, tears, detachments, or cancers in the eye.

Vitreous- the vitreous is the gel that fills the majority of the eye (like a water balloon) and is attached to the retina. A normal aging change to the eye is when the vitreous begins to shrink and pull away from the retina (posterior vitreous detachment) causing flashes of light and new floaters. A vitreous detachment can in some cases cause a retinal tear or detachment.

Retinal vasculature- the vessels in the retina are important for transporting blood supply to the retina and ensuring good vision. High blood pressure, high cholesterol, atherosclerosis, and diabetes can affect the blood supply tot he retina causing vision loss. Patients with these conditions require regular dilated exams to monitor for blockages or bleeding in the retina.

Auto-immune diseases such as Lupus and Rheumatoid arthritis can cause inflammatory problems with the eyes including inflammatory dry eyes, uveitis, episcleritis, scleritis, posterior uveitis, and keratitis. Patients with auto-immune diseases require regular dilated exams and close monitoring for any complications from their disease or medications.

Some medications can cause problems with the eyes and vision. Patients on certain medications such as anti-depressants, anti-inflammatories, anti-seizure medications, chemo-therapy, and many other medications require close monitoring of the eye health to catch any complications that could affect vision.

Certain medical problems of the eyes require more frequent monitoring. If your doctor recommends a follow up visit, medical insurance will cover any follow up visits according to the required treatment plan for your condition. In addition to examination of the eyes, certain tests may be ordered to aid in the diagnosis and treatment of some medical conditions.